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HomeMy WebLinkAbout0222 SWIFT AVENUE - Health 222 Swift Ave. , Osterville -003 -:,p 4tp A= 166-044 PA rfA I NIP k4 kAA" 11 1 AIR, am j 0 IRM11 IN, 4" TV MOO Omf xfm WE WIN;"'N'T �Irm kazi v VA%j got eii,ft" hill ON KOJI, 'X.nP "' %,� RT!,441,011-RAW 'OrVI f,T Rig; -*,fe gg jq� Map 1� R rob imp vgV mu'g NA th v ko long I-- Xg, 01 AV I 14 f It u vi Ri "174V gw', N "'MAR r% �4kl; -Mfl, :nfl P� J. 4-V,lq�"V�.' 'INMAM 1�1; 41 M 44 PIN , j - W fix .1 1T ffifit�w _41M®R H4 UM -3. p! - , I Rfilf� if 1 '4 up MIZA MOT ilk,�V NMI N,­XV WN, 4"1 1-1141,11 1 A` Vg J, n all, 11,01 ROOM gki �V, ilq III- Y. iR, moo t �4, a fy TWM ill i4 T,9 k,R, I U;TWN.4*C,,YO It?, MMV AREM kifit' too 1 Nil I iN fn 1A,1`1 �,Pt Z43 WAI� 44.............................. 41 A. A4 p.. !(0 6+-- fly TOWN OF BARNSTABLE LOCATION� ZZ-L cw, SEWAGE # 9 7 Zd VILLAGE ASSESSOR'S'MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY i Sa a LEACHING FACILITY:'(type) f 01PN Wt, (size) NO.OF BEDROOMS 2 UII,D OR OWNER PERMIT DATE: 2 ` COMPLIANCE DATE: ST -0 Separation Distance-Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by + .. ��`� t G� .. �_ � ._ . o` lb .36� 3y� -�5� v __ J No. 9 `n Fee d THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Migooar *pztem Construction Permit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. ?_2 2- Ste✓ A h S�. Owner's Name,Address and Tel.No. Slog- Assessor's Map/Parcel I L& 4¢,�, E 4>A L C-' CENTFII� c... Z /G/sf 024}2 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 7 7d=a.0 go A4,e- 4'A Pc E A.44"e- Type of Building: Dwelling No.of Bedrooms Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3I0 gallons per day. Calculated daily flow IAA.P gallons. Plan Date $-qt..-�1'9 Number of sheets B Revision Date Title PL-*A/ taooa Aduf&r Description of Soil f — /�'f ��► ��•-ti ��.�� P Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi and of Atalth. Signed Date Application proved by r Date PP Approved Application Disapproved for the following reasons Permit No. / Date Issued ^ Z TOWN OF BARNSTABLE LOCATION 22z .SL4 SEWAGE # 9 7 f�� VILLAGE ASSESSOR'S MAP& LOT - OW oa i INSTALLER'S NAME&PHONE NO.. H,c ke,. SEPTIC:TANK CAPACITY / \ LEACHING FACILITY: I w�,t t.t 1 1 ' , , (type) (size) %�� X fir! N0...OF BEDROOMS `Z UIID OR OWNER PERMITDATE: S/2 COMPLIANCE DATE: Vo Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Privaie.Water Supply Well and Leaching Facility (If any wells exist on site or within 200.feet of leaching facility) Feet `I Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished byQ . G�- �0 _ m Y No. :! 4/ Fee ►; 4.1 THE COMMONWEALTH OF MASSACHUSETTS -: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zlppfication for Mizpoml *pgtem Congtructioif Permit Application is hereby made for a Permit to Construct( )or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. 2-2 Z S w.Fr A✓.2 ©yr. Owner's Name,Address and Tel.No. `� 4 Assessor's Map/Parcel , ,.�,' 2� „ *.` ;. ..=' ^`�- G-�• . /ids 44-� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. AL L e3ui4_ Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder(Al*) Other Type of Building w/Z= No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Z-1 aG gallons per day. Calculated daily flow ' .7, gallons. Plan Date 4 Number of sheets s Revision Date Title t�*I AOI t�-:�t *�t_j oa..; 1� } Description of Soilm f Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this`B.oard of Ialth. Signed •-- Date �7 Application Approved by . Date Application Disapproved for the following reasons Permit No. 4ft; Date Issued /4? --------------------------------------- -- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance IS IS TO CERTIFY,that the On-site Sewage Disposal System installed(t')or repaired/replaced( )on by Installer at > .i has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. s dated - ' Date Inspector At cam✓ -.: � / i (..j THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS AI GUARANTEE THAT THE SYS- TEM WILL FUNCTION SATISFACTORY. ----------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migaaf Opgtem Construction Permit Permission is hereby granted to to construct repair( )an On-site Sewag. System located at No.# t� 6--4 Street and as described in the above Application for Disposal System Construction Permit. -7 v No. Date The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within three years of the date below. Date: 1 ; Approved by `e_ r121-4.")6 G�-7(-4 rat r& (I !� Board of Health SOIL EVALUATOR&PERCOLATION TEST FORMS Page I of 4 °FIMEr Town of Barnstable BARN9TAB Department of Health, Safety, and Environmental Services 9 MASS. En 39. 01 Public H Division 67© 367 Main S e yannis MA 02601 �fJ Office: 508-790.6265 FAX: 508-775-3344 4* APR SOIL SuAZ,l7IJ1 Ass e af�r� S wa e Dls osV NO. :! Date r� A. !-1h'S P. L. Date S . 3 Performed By: ��� � - Witnessed By: Location Address Owner's Name 1-uX+-3T'Z'V ZZ2 5� I rT AtiE �►S ►�► G�� c�. 0STL-,tiw I.LL E Lot#: Address,and OZ&°3 Z Assessor's Map/Parcel: (�C� [f[a—5Telephone# 'sQj- (o NEW CONSTRUCTION REPAIR I t Office Review Published Soil Survey vailable: No Yes ✓ Publication Scale Zs k— Soil map unit Year Published 3 —�'---- Drainage Class - Soil Limitations Surficial Geological Report Available: No Yes Year Published 191 Publication Scale L Geologic Material(Map Unit) CG?k Landform fE Flood Insurance Rate Map: Above 500 year flood boundary No Yes Within 500 year boundary No Y _ Yes Within 100 year flood boundary No X Yes 5 ' Wetland Area: a National Wetland Inventory Map(map unit) s Wetlands Conservancy Program Map(map unit) Current Water Resource Conditions(USGS): Month ��{4 Range: Above Normal Normal Below Normal Other References Reviewed: DEP APPROVED FORM-12/07/95 s. 14%' FORM 11 - SOIL EVAIXATOR FORM . : Page 1,of> Localion Address or Lot No. Z22 5-kavf-T /�iIEI d5i-c'�✓� LC� Oil-site Review Deep Hole Number 2 Date: 51,0 11& Time: IV;,o o Weather Location (identify on site plan) Land Use eE!n-ve*--v+ -mot- Slope M Surface Stones Vegetation 'Pt ►-' A C>h� Landform V-e,41G Position on landscape (sketch on the back) Distances from: Open Water Body PIA, feet Drainage way P/& feet Possible Wet Area OA feet Property Line Ip-}- feet Drinking Water Well 131A, feet Other DEEP OBSERVATION HOLE LOG' Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(inches) (USDA) (Munsell Mottling (Structure,Stones, Boulders, Consistency, % Gravel S- to 4/3 sib `LYE s/s P a Gi � toe, - 1 t-v o O q- C' LCIT49-ky 11LCA,ty P l j� Z�- 4& MINIMUM OF 2 HOLES REQUIRED AT EVERY PROPOSED DISPOSAL AREA Parent Material (geologic) I-r--1°tv--s -T-�'6p0 a1'ZS DepthtoBedrock: c7w Depth to Groundwater: Standing Water in the Hole: Weeping from Plt Face: Estimated Seasonal High Ground Water: l DE:P APPROVED FORM• 1210719S FORM l I - Soil, LVALL►ATOlt F0109 Page 3 oUA yi t :Zv. Location Address or Lot No. ZZZ Determination for Seasonal High Water Table Me _ thod Used: » �--� ❑ Depth observed standing in observation hole inches ❑ Depth weeping from side of observation hole.. :. inches ❑ Depth to soil mottles inches El Ground water adjustment ................. ee Index Well Number ........ :. . Reading Date ................. Index well level .' Adjustment factor .... Adjusted ground water level ......... ................ ..:. . . 14 4 Depth of Naturally Occurrin4 Pervious Material Does at least four feet of naturally occurring pervious material e in , II areas observed throughout the area proposed for the soil absorption system? It If not, what is the depth of naturally occurring pervious material? Certification - I certify that on « q (date) I have passed the soil evaluator examination approved by the Departmen of Environmental Protection and that the above analysis was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017. Date S 3 S Signature + . � i,♦R UEP APPROVED FORM-12/07/95 � P. ,3 FORM 12 - PERCOLATION TEST Page 4 of 4 Yy Location Address or Lot No. p5� COMMONWEALTH OF MASSACHUSETTS t_..E , Massachusetts Percolation Test Date: 5ko S Time:, Observation Hole # Depth of Perc it Start Pre-soak End Pre-soak Time at 12" Z_ q'i Time at 9" Time at 6" Time (9"-6") Rate Min./Inch G Z " I 0A �..� Minimum of 1 percolation test must be performed in both the primary area AND reserve area. Site Failed ❑ ...-.,.....- SitePassed ..:......................................—_... Performed By: Witnessed By: comments: .:...::..:....:.:::�...:.v:�...�sw:.....�..._:...�::..:...:........:....�..,............,. Comm :: ..:...:::.::..::..:.. DEP APPROVED FORM-1210119S I 1 i, V i 4'1- it J .­J P. 17 I r i F F 4 t .4 T-I 1 � ( k F V �-k t � � S M F i E ' {� � -� � � i. -IF i I J m J_ t T-t ao 4, SW 4X C, Ave 1 AL I i '�6-1 13A A Lotlareia - 22, 302 d f Ij I 33f wide C j J• A-T 47- Ai t Pirof ile no, Scale NO C/164 A�/ t 1 4 P v 1500 Fr ........... 04 j GSTi %4 t T I i j '5�r,�L "I . N; ' 4 4P -aj& F F.1 A-.0 49?4J 40 17 &�C—L :.Septa cl. design' ► Use 8 high tk, inf il' iNolbeidroomsl ii v-3 i j capacity. trators �iith, stones as ; 9 1 , I .Req.Jeaching 33b;-' pd! I shown. eg,. ,i tank i i 1 i 15W gal. 1 1 iDipposai-, i i ! no i ---Leaching' provided T '1 1-915 9 4' 3 6 0. 7,499!..�F 2 6 ,78x' 2 6x' 7 44 115,.4: 4- —------- f , -I 4"r i,god ; - , vs Lr,sX&M)k S, 45. 0-44 W*.4,' 1 n. I 461 dV 4=0 Q,-Mj�A-740 iz> 4!r j 3 Land' plan' of nd; in Ostervill Sit: e MA; For` Kurt, Turhbpll Being lot: asp shown, in pl: n� book} 354, page 99 . ; Elev' a' fJon' s' are' on' U S G S' Oaturn I 4 1 Health Date­­l Agent Barnstable Bo4rd' 6f Scale' 11'=301 'date, '16?--9 7 4- -Map-L.116-6 parcel: -4. 3 All Cape- Test: pit P-8704- 49, Harbor Road: Made: 5'?� 30-961 Hy' a* nnis: MA 02601' Wit, Ed, Barry' No' water; encountered- TT P Jl' t T 2. 34.3 LN E • 32490 4 4i 'l ..........